AVPU
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AVPU
The AVPU scale (an acronym from "alert, verbal, pain, unresponsive") is a system by which a health care professional can measure and record a patient's level of consciousness. It is mostly used in emergency medicine protocols, and within first aid. It is a simplification of the Glasgow Coma Scale, which assesses a patient response in three measures: eyes, voice and motor skills. The AVPU scale should be assessed using these three identifiable traits, looking for the best response of each. Meaning of the mnemonic The AVPU scale has four possible outcomes for recording (as opposed to the 13 possible outcomes on the Glasgow Coma Scale). The assessor should always work from best (A) to worst (U) to avoid unnecessary tests on patients who are clearly conscious. The four possible recordable outcomes are: * Alert: The patient is fully awake (although not necessarily oriented). This patient will have spontaneously open eyes, will respond to voice (although may be confused) and will have b ...
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Level Of Consciousness
An altered level of consciousness is any measure of arousal other than normal. Level of consciousness (LOC) is a measurement of a person's arousability and responsiveness to stimuli from the environment. A mildly depressed level of consciousness or alertness may be classed as lethargy; someone in this state can be aroused with little difficulty. People who are obtunded have a more depressed level of consciousness and cannot be fully aroused. Those who are not able to be aroused from a sleep-like state are said to be stuporous. Coma is the inability to make any purposeful response. Scales such as the Glasgow coma scale have been designed to measure the level of consciousness. An altered level of consciousness can result from a variety of factors, including alterations in the chemical environment of the brain (e.g. exposure to poisons or intoxicants), insufficient oxygen or blood flow in the brain, and excessive pressure within the skull. Prolonged unconsciousness is unde ...
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Glasgow Coma Scale
The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury. The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These three behaviours make up the three elements of the scale: eye, verbal, and motor. A person's GCS score can range from 3 (completely unresponsive) to 15 (responsive). This score is used to guide immediate medical care after a brain injury (such as a car accident) and also to monitor hospitalised patients and track their level of consciousness. Lower GCS scores are correlated with higher risk of death. However, the GCS score alone should not be used on its own to predict the outcome for an individual person with brain injury. Scoring The Glasgow Coma Scale is used for people above the age of two and composed of three tests: eye, verbal, and motor responses. The scores for each of these tests are indicated in the table below. The Glasgow Com ...
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Pain Stimulus
Pain stimulus is a technique used by medical personnel for assessing the consciousness level of a person who is not responding to normal interaction, voice commands or gentle physical stimuli (such as shaking of the shoulders). It forms one part of a number of neurological assessments, including the first aid based AVPU scale and the more medically based Glasgow Coma Scale. The objective of pain stimulus is to assess the level of consciousness of the patient by inducing vocalisation in an acceptable, consistent and replicable manner, and to this end, there are a limited number of techniques which are normally considered acceptable. The pain stimulus can be applied centrally and/or peripherally, and there are benefits and drawbacks to each type of stimulus, depending on the type of patient and the response being assessed. Central stimuli A central stimulus is one which can only be successfully found if the brain is involved in the response to the pain (as opposed to peripheral ...
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Sternal Rub
Pain stimulus is a technique used by medical personnel for assessing the consciousness level of a person who is not responding to normal interaction, voice commands or gentle physical stimuli (such as shaking of the shoulders). It forms one part of a number of neurological assessments, including the first aid based AVPU scale and the more medically based Glasgow Coma Scale. The objective of pain stimulus is to assess the level of consciousness of the patient by inducing vocalisation in an acceptable, consistent and replicable manner, and to this end, there are a limited number of techniques which are normally considered acceptable. The pain stimulus can be applied centrally and/or peripherally, and there are benefits and drawbacks to each type of stimulus, depending on the type of patient and the response being assessed. Central stimuli A central stimulus is one which can only be successfully found if the brain is involved in the response to the pain (as opposed to peripheral s ...
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First Aid
First aid is the first and immediate assistance given to any person with either a minor or serious illness or injury, with care provided to preserve life, prevent the condition from worsening, or to promote recovery. It includes initial intervention in a serious condition prior to professional medical help being available, such as performing cardiopulmonary resuscitation (CPR) while waiting for an ambulance, as well as the complete treatment of minor conditions, such as applying a plaster to a cut. First aid is generally performed by someone with basic medical training. Mental health first aid is an extension of the concept of first aid to cover mental health, while psychological first aid is used as early treatment of people who are at risk for developing PTSD. Conflict First Aid, focused on preservation and recovery of an individual's social or relationship well-being, is being piloted in Canada. There are many situations that may require first aid, and many countries hav ...
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Glasgow Coma Scale
The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury. The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These three behaviours make up the three elements of the scale: eye, verbal, and motor. A person's GCS score can range from 3 (completely unresponsive) to 15 (responsive). This score is used to guide immediate medical care after a brain injury (such as a car accident) and also to monitor hospitalised patients and track their level of consciousness. Lower GCS scores are correlated with higher risk of death. However, the GCS score alone should not be used on its own to predict the outcome for an individual person with brain injury. Scoring The Glasgow Coma Scale is used for people above the age of two and composed of three tests: eye, verbal, and motor responses. The scores for each of these tests are indicated in the table below. The Glasgow Com ...
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Human Eye
The human eye is a sensory organ, part of the sensory nervous system, that reacts to visible light and allows humans to use visual information for various purposes including seeing things, keeping balance, and maintaining circadian rhythm. The eye can be considered as a living optical device. It is approximately spherical in shape, with its outer layers, such as the outermost, white part of the eye (the sclera) and one of its inner layers (the pigmented choroid) keeping the eye essentially light tight except on the eye's optic axis. In order, along the optic axis, the optical components consist of a first lens (the cornea—the clear part of the eye) that accomplishes most of the focussing of light from the outside world; then an aperture (the pupil) in a diaphragm (the iris—the coloured part of the eye) that controls the amount of light entering the interior of the eye; then another lens (the crystalline lens) that accomplishes the remaining focussing of light into ...
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Voice
The human voice consists of sound made by a human being using the vocal tract, including talking, singing, laughing, crying, screaming, shouting, humming or yelling. The human voice frequency is specifically a part of human sound production in which the vocal folds (vocal cords) are the primary sound source. (Other sound production mechanisms produced from the same general area of the body involve the production of unvoiced consonants, clicks, whistling and whispering.) Generally speaking, the mechanism for generating the human voice can be subdivided into three parts; the lungs, the vocal folds within the larynx (voice box), and the articulators. The lungs, the "pump" must produce adequate airflow and air pressure to vibrate vocal folds. The vocal folds (vocal cords) then vibrate to use airflow from the lungs to create audible pulses that form the laryngeal sound source. The muscles of the larynx adjust the length and tension of the vocal folds to 'fine-tune' pitch and ton ...
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Motor Skill
A motor skill is a function that involves specific movements of the body's muscles to perform a certain task. These tasks could include walking, running, or riding a bike. In order to perform this skill, the body's nervous system, muscles, and brain have to all work together. The goal of motor skill is to optimize the ability to perform the skill at the rate of success, precision, and to reduce the energy consumption required for performance. Performance is an act of executing a motor skill or task. Continuous practice of a specific motor skill will result in a greatly improved performance, which leads to Motor Learning. Motor learning is a relatively permanent change in the ability to perform a skill as a result of continuous practice or experience. Types of motor skills Motor skills are movements and actions of the muscles. There are two major groups of motor skills: *Gross motor skills – require the use of large muscle groups in our legs, torso, and arms to perform tasks such ...
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Abnormal Posturing
Abnormal posturing is an involuntary flexion or extension of the arms and legs, indicating severe brain injury. It occurs when one set of muscles becomes incapacitated while the opposing set is not, and an external stimulus such as pain causes the working set of muscles to contract.AllRefer.com. 200"Decorticate Posture". Retrieved January 15, 2007. The posturing may also occur without a stimulus.WrongDiagnosis.com(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series). Retrieved on September 15, 2007. Since posturing is an important indicator of the amount of damage that has occurred to the brain, it is used by medical professionals to measure the severity of a coma with the Glasgow Coma Scale (for adults) and the Pediatric Glasgow Coma Scale (for infants). The presence of abnormal posturing indicates a severe medical emergency requiring immediate medical attention. Decerebrate and decorticate posturing are strongly associated with poor outcome in a variety ...
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Unconsciousness
Unconsciousness is a state in which a living individual exhibits a complete, or near-complete, inability to maintain an consciousness, awareness of self and environment or to respond to any human or environmental Stimulus (physiology), stimulus. Unconsciousness may occur as the result of traumatic brain injury, Cerebral hypoxia, brain hypoxia (inadequate oxygen, possibly due to a brain infarction or cardiac arrest), severe intoxication with drugs that Depressant, depress the activity of the central nervous system (e.g., Alcohol (drug), alcohol and other hypnotic or sedative drugs), severe fatigue, pain, Anesthesia, anaesthesia, and other causes. Loss of consciousness should not be confused with the notion of the Unconscious mind, psychoanalytic unconscious, cognitive processes that take place outside awareness (e.g., implicit cognition), and with altered states of consciousness such as sleep, delirium, hypnosis, and other altered states in which the person responds to stimuli, in ...
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Emergency Medical Services
Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS. In most places, the EMS can be summoned by members of the public (as well as medical facilities, other emergency services, businesses and authorities) via an emergency telephone number which puts them in contact with a control facility, which will then dispatch a suitable resource for the situation. Ambulances are the primary vehicles for delivering EMS, though some also use squad cars, motorcycles, aircraft, or boats. EMS agencies may also operate a non-emergency patient transport service, and some have rescue squads to provide technical rescue services. As a first resort ...
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